Evaluation Moderna Booster Vaccine Recipient Questionnaire for

Health Workers in Pharmacies and Hospitals Among Indonesian

Citizens

Seftian Putra Dwijaya Marpaung and Diana Laila Ramatillah

Faculty Pharmacy, Universitas 17 Agustus 1945 Jakarta, Indonesia

Keywords: Booster Vaccine, Moderna, Pharmacy/Clinical Health Workers, Hospital/Public Health center Health

Workeers

Abstract: Evaluating the compparison of the effectivennes and adverse effect following immunization of the Moderna

boster vaccine against Health workers in Hospital and Pharmaciesin Indonesia and other factors that influence

it. This study was a cross-sectional observational study using convenience sampling in 603 respondents

working as hospital workers and pharmacists in Indonesia vaccinated with the Moderna booster vaccine, data

analysis using SPSS version 25 and Cronbac'h I am using the result with the alpha of 0.600. It was found that

the efficacy of the Moderna Booster Vaccine on Hospital/Public health center Health Workers and

Pharmacy/Clinic Health Workers (87.42% and 96.4%). Other factors that influence adverse effects following

immunizations and vaccine efficacy are gender, age, and BMI (Body Mass Index) with a p-value of each

variable < 0.05. The study data show that the efficacy of Moderna booster vaccines varies in the mode of

action. The data show that the efficacy of the latest vaccine for HCWs working in hospitals/abscesses is 96.4%

higher than the efficacy of the latest vaccine for HCWs working in pharmacies/clinics. Common adverse

effects following immunizations after the Moderna booster injection are arm pain, fever, flu, and cough, but

the adverse effect following immunizations of nausea is more common in health workers working in

pharmacies/clinics 18.27%, compared to health workers working in hospitals/health centers 11.92%.

1 INTRODUCTION

The Novel Coronavirus (SARS-CoV-2) is spreading

from Wuhan city Hubei Province, China to the whole

corner of the world. Coronavirus is a sense RNA virus

positive with starting diameter from 60 nm to 140 nm

with a bulge-like nail on the surface that makes it look

like a crown below a microscope electron (Singhal,

2020). As of May 30, 2022 (11.13 GMT+7) total

Covid- 19 cases recorded worldwide have reached

more than 531 million cases soul with Dead more than

6.3 million souls. Vaccines could stimulate system

immunity receivers to prevent or reduce the

possibility of infection-exposed pathogens. The

vaccine is an attenuated virus, vaccine uses

pathogenic strains that have been weakened to become

non-infectious in non-human tissues, which are then

injected into the recipient and are called by the

immunity body.

With 6 different vaccines currently in use in

Indonesia, Moderna's vaccine has high efficacy, 94-

95% compared to other vaccines already in Indonesia,

making Moderna one of the best vaccines. (Araminda

& Ramatillah, 2022a). The high death toll associated

with Covid-19 is common in frontline energy

medicine to combat Covid-19. Therefore, medical

personnel will be prioritized for her Covid-19 vaccine

booster (Klugar et al., 2021). The Ministry of Health

of the Republic of Indonesia provides a Covid-19

booster vaccine that has passed clinical, which has

could be used for whole power health both those on

duty at pharmacies, clinics, health centers, and homes

Sick that is Moderna Booster Vaccine (Tenzin &

Dorji, 2020).

The US Food and Drug Administration (FDA)

and the European Medicines Agency (EMA) first

approved booster vaccines, they are in " group

priority " (parents 65 years old to top, people with

disease attendant, officer health, and travel. (Overseas

people) Residents of the " region risky high " will

accept the first booster dose (dose third) between

December 24 and 31, 2021. NITAG (National

Immunization Technical Advisory Groups)

Marpaung, S. and Ramatillah, D.

Evaluation Moderna Booster Vaccine Recipient Questionnaire for Health Workers in Pharmacies and Hospitals Among Indonesian Citizens.

DOI: 10.5220/0011979100003582

In Proceedings of the 3rd International Seminar and Call for Paper (ISCP) UTA â

Z45 Jakarta (ISCP UTA’45 Jakarta 2022), pages 225-231

ISBN: 978-989-758-654-5; ISSN: 2828-853X

 2023 by SCITEPRESS – Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)

225

recommends gift mRNA vaccine (Pfizer or Moderna)

for individual booster immunization heterologous. As

of January 1, 2022, about 170,000 people (93% of

group priority) get booster injections(Naully et al.,

2022)

Moderna booster It is a -based messenger RNA

(mRNA). The vaccine with packaged in lipid

nanoparticles (NP), material viral genetic material

(mRNA), in which a spike glycoprotein can give code

on the body that causes sticks to the cells host. That's

what causes the body to build immunity against the

SARS-CoV2 (S) virus, Ingredients vaccine Moderna

are ribonucleic acid (mRNA), and fats consisting of

(SM- 102, Polyethyleneglycol(PEG)2000,

dimyristoyl glycerol(DMG), Cholesterol, 1,2-

Distearoylsn-glycerol-3-phosphocholine(DSPC),

tromethamine, Tromehamin hydrochloride,

acid acetate, sodium acetate, and sucrose (6).

Due to amount cases that have increasingly been

exposed to Covid 19 increase so is the amount of

power health workers exposed to COVID-19.

University of Oxford Medical Evidence Center

(Driggin et al. 2020) states that 13.8% of cases

positive is worker key main in-service health and

sector other. On April 16, 2019, the number of

workers with key critical positive- increased to

16.2%. This has a significant impact on the load -of

work and stress of frontline workers main, the

weakened ability of system care health to handle

problems. Situation this implication is whether you

are serious to Keep going increase the amount of

power health infected with COVID-19. Remember

risk to personal, and professional health is often

considered Required to do it. Obligation this set in the

guiding Code of Ethics for professional health.

However, system-effective health- doesn’t only

depend on the service and skills of professional

medical like doctors and nurses. But it also depends

on the service professional other (Nyashanu et al.,

2020). Although the related data with efficacy and

adverse effect following immunizations about

Moderna booster vaccine already there is. Study

clinical more carry on required about comparison

evaluation Among power health work at home sick

and those at the clinic/pharmacy in the workforce

receiving medical Moderna booster vaccine with

seeing various other aspects such as possible

sociodemographics existence linkages with efficacy

nor adverse effect following immunization from

vaccines used.

2 MATERIALS AND METHODS

2.1 Design

This study used a prospective cross-sectional study to

evaluate the comparison of efficacy and adverse

effect following immunizations between health

workers working in hospitals/Public health centers

and health workers at pharmacies/clinics using a

questionnaire. This research was conducted for 3

months (September – November). For the sampling

technique using convenience, sampling through all

items that make up the research inclusive criteria.

Inclusion criteria were all hospital health

workers/health centers and pharmacy/clinic health

workers in Indonesia who had carried out the

Moderna Booster Vaccination and were willing to

give informed consent to be included in the study.

Exclusion criteria were all Hospital/Public health

center health workers and Pharmacy/Clinical health

personnel who had not performed the Moderna

booster vaccination, Indonesian people suffering

from cancer (stages 3&4), HIV/AIDS sufferers, TB

patients, autoimmune patients (Lupus patients).

2.2 Participants

The participants in this study were all Hospital/Public

health center health personnel and Pharmacy/Clinic

health workers who had been vaccinated with the

Moderna booster with a total of 600 respondents, and

adverse events. A p-value of 0.05 was considered

significant.

2.3 Instruments

This study uses a questionnaire distributed through

social media (WhatsApp, Twitter, Facebook,

Instagram, and Telegram). The number of

questionnaires in this study was 50 questions on

identity and comorbidities. The 50 questions were

about the adverse effect following immunizations

received after the first and second doses of

vaccination in the short and long term, as well as

monitoring the adverse effect following

immunizations of the vaccine for 1-6 months after

being vaccinated.

2.4 Statistical Analysis

The collected results were analyzed using the SPSS

version 25 application. Fisher, Chi-square, Mann-

Whitney, and Kruskal-Wallis tests were used to find

associations between risk factors (gender, age, BMI,

ISCP UTA’45 Jakarta 2022 - International Seminar and Call for Paper Universitas 17 Agustus 1945 Jakarta

226

Negative

Positive

vaccine type) and adverse events. A p-value of 0.05

was considered significant.

2.5 Ethical Approval

As stated in Figure 1, ethical approval was obtained

before conducting the research from the health

research ethics committee of the University of 17

August 1945 Jakarta, with approval

letterNo.53/KEPK-UTA45JKT/EC/EXP/08/2022

3 RESULT AND DISCUSSION

3.1 Prevalence of Participants by

Domicile

This research was conducted spread throughout

Indonesia with the percentage of domicile of each

respondent 1.16% from West Sumatra Province,

3.48% from South Sumatra Province, 4.81% from

North Sumatra Province, 22.06% from DKI Jakarta,

Yogyakarta province, 0.17% came from Malaysia,

36.48% came from West Java province, 9.95% came

Figure 1: Prevalence of participants by domicile.

Figure 2: Vaccine Recipient .

3.81% from the Province of Kalimantan, 0.33% came

from Sulawesi Province, 1.66% came from from

Central Java province, 15.75% came from East Java

province, and 0.33% came from the province of Bali,

as shown in figure 1. Domicile is not one of the factors

that influence the adverse effect following

immunizations and vaccine efficacy, this can be seen

from the absence of significance between these two

varieties.

3.2 Vaccine Recipient and Presentation

of Positive Covid - 19

The relationship between the Moderna booster

vaccination status carried out on health workers

working in hospitals/health centers and

pharmacy/clinic health workers with the incidence of

Covid-19 shows that the analysis of the data that has

been obtained includes health workers in

hospitals/health centers who are more exposed to

covid after being hospitalized. Vaccination compared

to pharmacy/clinic health workers ‘(Pratama et al.,

2022) which in hospitals/public health centers as

many as 12.58% (n = 302) have been confirmed

positive for Covid-19, while in pharmacies or clinics

as many as 3.6% (n = 301) have been confirmed

positive for Covid-19. This is because health workers

who work in hospitals and health centers directly

interact with Covid- 19 patients so they are more

susceptible to being exposed to Covid-19 than health

workers who work in pharmacies/clinics (Pharmd,

2021).

Figure 3: Presentation of Positive Covid – 19.

Presentation of positive covid-19

120.%

100%

80%

96.34%

87.41%

60%

40%

20%

12.6%

3.65%

Pharmacy Hospital Healt/

Health/ Clinic Public Health Workcare

Evaluation Moderna Booster Vaccine Recipient Questionnaire for Health Workers in Pharmacies and Hospitals Among Indonesian Citizens

227

Table 1: Association between Work Place with Covid Status.

Factor Hospital/Health Care

(n=302)

Pharmacy/Clinic (n = 301) p-value

Positive Covid-19 Yes = 38

No = 264

Yes = 11

No = 290

0.0001

Symptoms No Symptoms = 16

Mild Symptoms = 25

Moderate Symptoms = 6

Severe Symptoms = 1

ever Ge

Infected = 254

No Symptoms = 4

Mild Symptoms = 8

Moderate Symptoms = 1

Severe Symptoms = 1

ever Ge

Infected = 287

0.0001

Increase D- Dimer Yes = 6

No = 46

ever Ge

Infected = 250

Yes = 1

No = 21

ever Ge

Infected = 279

0.0001

Hospitalized Home Isolation = 35

Hospital Non- ICU = 5

Hospital ICU = 1

ever Ge

Infected = 261

Home Isolation = 13

Hospital Non- ICU = 0

Hospital ICU= 1

ever Ge

Infected = 287

0.0001

Positive Covid-19 (1

to 3 months)

Yes = 20

No = 282

Yes = 4

No = 297

0.0001

Positive Covid-19 (4

to 6 months)

Yes = 15

No = 287

Yes = 5

No = 296

0.038 *

= Chi-squared,

= Fisher's Exact

3.3 Association Between WorkPlace

with Covid Status

The results of the weekly morbidity and mortality

report on the effectiveness of the third dose of the

Moderna booster vaccine show that

immunocompromised adults received the third dose

of the mRNA vaccine 28 days after the second dose

and the currently recommended third dose (booster) 5

months after the second dose. Emphasizes the

importance of people immunocompromised adults

who are immunocompromised (10). COVID-19

booster vaccine was introduced in the UK on

September 14, 2021. Of course, only, using proof

from COV- BOOST studies showing that mRNA

vaccines have a powerful booster effect with

reactivity low miss from vaccine main given, English

for immunizations and immunizations The Joint

Committee recommends BNT162b2 or health centers

and health workers in pharmacies or clinics, are fever

(55.6% and 56.14%), and pain in the injection area

(75.8% and 77.4%, Cough (13.9% and 13.2%), Flu

(17.8% and 18.9%), Nausea (11.9% and 18.2%),

Headache (41% and 48.5%), Drowsiness (44.3% and

43.5), Bleeding (1.6% and 1.6), the upper shoulder

joint (64.2% and 62.4%), Diarrhea (5.9% and 5.3%)

or vaccine half dose (50g) mRNA-1273 (Moderna) as

a booster dose in 6 months after finishing the series

vaccination main. (Andrews et al., 2022). From a

comparative study of symptoms and antibody

response after administration of the Moderna vaccine

or SARS-CoV-2 Pfizer, it was found that the antibody

response decreased at 6 months, an 84% reduction in

Moderna but still higher than in convalescent donors.

Antibody response did not correlate with gender or

symptom severity (Kelliher et al., 2022).

In the study of absorption of booster doses of

COVID-19 among residents of Saudi Arabia, the

results of the occurrence of adverse effects following

immunizations at the second dose (p<0.01), COVID-

19 infection (p=0.006), the severity of COVID-19

symptoms (p<0.01), had COVID-19 after receiving

both doses (p<0.01) ), and the type of presenting

symptom (p = 0.028) were significantly associated

with decreased absorption of the COVID-19 booster

dose (Kelliher et al., 2022) the most common adverse

effect following immunizations that occur after

Moderna booster vaccination, with a comparison of

health workers in hospitals.

3.4 Correlation Between WorkPlace

with Adverse Effects Following

Immunizations

According to the WHO, a common adverse effect

following immunizations after vaccination is

injection site pain, fever, fatigue, headache, muscle

aches,

chills, diarrhea, and a less common adverse

ISCP UTA’45 Jakarta 2022 - International Seminar and Call for Paper Universitas 17 Agustus 1945 Jakarta

228

Table 2: Correlation between Workplace with Adverse effects following immunizations.

Adverse effects following

immunizations

Hospital/Healthh Care (n =

302)

Pharmacy/Clinic (n =

301)

p-value

Fever Yes = 168

o = 134

Yes = 169

o = 132

0.935 *

Pain at Injection Yes = 229

o = 73

Yes = 233

o = 68

0.701 *

Cough Yes = 42

o = 260

Yes = 40

o = 261

0.906 *

Flu Yes = 54

o = 248

Yes = 57

o = 244

0.754 *

Nausea Yes = 36

o = 266

Yes = 55

o = 246

0.031 *

Headache

Yes = 124

o = 178

Yes = 146

o = 155

0.072 *

Sleepy Yes = 134

o = 168

Yes = 131

o = 170

0.870 *

Bleeding Yes = 5

o = 297

Yes = 5

o = 297

1,000 *

Upper arm Yes = 194

o = 108

Yes = 188

o = 133

0.673 *

Pain In area Injection Yes = 18

o = 284

Yes = 16

o = 285

0.860 *

effect following immunization is a severe allergic

reaction (14). In a study conducted in the United

States, the adverse effect following immunizations of

the Moderna vaccine was fever (35.65%), headache

(59.26%), arm pain (94.21%), nausea (26.62%), and

chest pain (1.85%) ‘(Araminda & Ramatillah,

2022b).

The most commonly reported adverse effect

following immunizations of the Moderna booster

vaccine include injection site pain, headache, malaise,

muscle aches, malaise, chills, arthralgia, mucosal

lesions, oral paresthesias, taste disturbances, itching,

rash, itchy mouth and throat, and throat blockage.

reported, muscle cramps, loss of appetite, poor sleep

quality, diarrhea, hot flashes, nasal congestion, and

difficulty breathing. Local reactions at the injection

site, such as urticaria and urticarial rash, have also

been reported (Ananth et al.,2021)

In several other studies, adverse effects following

immunizations were more common in the Moderna

group after the first and second doses. Mild pain at the

injection site is common and lasts about 3 days.

However, delayed injection site reactions such as

erythema, tenderness, and induration are rare and

generally resolve within 4-5 days. Fatigue, myalgia,

arthralgia, and headache increased after the second

dose of the Moderna vaccine and lasted for

approximately 3 days. The adverse event rate in the

Moderna arm was independent of age and had no

sequelae.

In 18 other studies, adverse effects following

immunizations included localized axillary swelling or

tenderness ipsilateral to the injection site and

generalized rash (Francis et al., 2022). In a study of

adverse effects following immunizations of Moderna

vaccines in Bangladesh, it was stated that the most

common were pain at the injection site (97%), fever

(91%), headache (68.29%), and redness/swelling at

the injection site (70%) ‘(Mahmudetal.,2022) From a

study evaluating the prevalence of adverse effects

following immunizations associated with booster

doses of mRNA-based Covid-19 vaccines among

health workers in the Eastern Province, Saudi Arabia.

Get results from study ie, 81. 84% (401/490) of

professionals participating in health report at least one

effect side after accepting of COVID-19 vaccine. 3

(1-4) effects side reported (median (IQR)), (88. 73%)

reported, effect most frequent side reported is the sick

head (28.68%), painful joints or bone (27.18%),

myalgia (26.43%), nausea or vomiting (21.2%), fever

(18.95%), and rash (10.22%), whereas effect the

rarest side reported is redness the place injections

(8.23%), chills (7.98%), fatigue (7.73%), and

swelling the place injection. delayed menstruation

(Ali et al., 2022)

In the COVID-19 phase 4 vaccine candidate

study, the effectiveness of SARS- CoV-2 variants,

Evaluation Moderna Booster Vaccine Recipient Questionnaire for Health Workers in Pharmacies and Hospitals Among Indonesian Citizens

229

neutralizing antibodies, rare adverse effect following

immunizations, and traditional and nano-based

vaccine platforms were demonstrated by the

participant who accept two doses of mRNA-1273 28

days after the dose first. All participants were -shaped

into three groups (n = 15) according to doses of 25

g,100 g, or 250 g (Jackson et al. 2020). Response

more antibodies strongly reported(Naully et al., 2022)

after the dose first vaccine, 5 participants (33%) in the

25-gram group, 10 participants (67%) in the 100-gram

group, and 8 participants (53%) in the 250-gram

group reported effects of side light or medium. After

the dose second, 7 of 13 (54%) participants were in a

group of 25 g, 15 of 15 (100%) participants in the 100

g group, and the g group in a group of 250 grams.

Three participants in the 250-gram group reported one

or more effect serious side. For fever, no some

participants experienced fever after the dose first

(Zarreen et al., 2022)

4 CONCLUSION

The research data shows that there are differences in

the effectiveness of the Moderna booster vaccine in

the typpe of work; where in the data shows the

effectiveness of Moderna vaccine is found to be

higher in health workers working in hospitals/health

centers by 96.4% compred to the effectiveness of

Moderna vaccine in health workers who work in

Pharmacies/clinic by 87.43%. The adverse effect

following immunization nausea is the highest for

health workers who work in

pharmacies/clinics,which is 18.27%,compered to

health workers who work in hospital/helath centers by

11.92%.

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